Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | CH00001133 | WA |
Y | 213ER0200X | Radiology | CH00001133 | WA |
NPI | 1023119328 |
---|---|
Provider Name | Dr. Diann Kale |
First Address | East Wenatchee, WA 98802-5348 |
Second Address | East Wenatchee, WA 98802-5348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 17/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0911462790-00 | MEDICADE (01) | WA |
74999 | L & I (01) | WA |
G000315137 | MEDICARE (01) | WA |
T02513 | (02) | WA |